kellbell1

Hello everyone, Its been a long time since I've posted anything. But I'm back and I have a really serious question. I have a 3.78 GPA and finished all my prereqs for Valencia Community College, however I am taking Sociology for Seminole Community College. I am going to do the LPN-RN transition program. I have applied to Valencia and waiting for a response. The program starts January 2009. I also want to start the Seminole program in June 2009. My question is which school seems to be the best program overall?(LPN-RN transition program) Any advice or suggestions will be extremely helpful. Thanks in advance.

Is the agency Universal Home Care. That is an agency located in Beverly Hills. I used to work for them as a LPN and they paid $20-$22/hr. Let me know if it is.

Are there any registry nurses who feel they stick out like a "sore thumb" in the hospital? You will feel better when you read this article: Many staff nurses look at the registry nurse as some kind of second-class, poorly trained, third cousin to the staff nurse. This myth, in most cases, cannot be further from the truth. I have seen very competent registry nurses given lousy assignments by the charge nurse under the misguided belief that registry nurses aren't "real" nurses, or are less skilled than the hospital's own staff nurses. Are there bad or poorly trained registry nurses? Of course, just as there are bad or poorly trained staff nurses. Sure, the staffer will be more familiar with that particular hospital's protocols. But just because a nurse has chosen to practice nursing through a registry should not lead anyone, let alone another nursing professional, to believe that this nurse is any less committed to quality patient care than the nurse who has chosen to practice in the hospital setting. Our profession suffers from enough outside detractors--we do not need to join the fray as well. Several years ago I was working, through the registry, at a local Los Angeles hospital. I got called down to the ED from the NICU to start a particularly difficult IV on an infant, when the baby's mother objected to my performing the procedure. She had realized that I was not one of the regular staff RN's, since I wore my registry I.D. rather then the standard hospital I.D. The head nurse apologized to me for calling me away from my patients and sent me back to the unit. Perhaps if the head nurse had explained that the reason the ED nurses had called me down was because they knew I could start an IV in the most difficult of cases and they wanted to avoid repeatedly sticking her child--perhaps then, the mother may have let me perform the procedure. Or maybe not. But at least she would have made her decision based on facts, rather then the mistaken belief that registry nurses are somehow less skilled than staff nurses. What draws one nurse to the hospital setting and another to the registry are different challenges. Some of the reasons that a nurse may choose to work for a registry or travel agency are: * Not to have to deal with the hospital politics So many nurses are driven out of bedside nursing because of the hospital/nursing politics of a particular institution. When a nurse works through the registry, she usually shields herself from the day-to-day politics since she is there on a temporary assignment. She doesn't need to invest emotionally in interoffice concerns. Consequently, registry nurses may be less likely to suffer from burnout than staff nurses. * Have more direct control over their work schedule Working the registry usually allows the nurse to have greater control over her work schedule. She can stipulate the days and shifts she is willing to work, and when she is not. Most registry managers recognize this as one of the satisfaction indicators for their nurses and they usually do their best to accommodate requests. However, when the need arises, they call their list of available nurses to see if one wants to pick up an additional shift. When this happens, the nurse has the right to refuse without suffering consequences. Furthermore, the nurse can often negotiate higher pay for the assignment or other bonuses. * To make extra money There is no question that registry and travelers generally make more money per hour then the permanent nursing staff. This is the case in most professions where a "substitute" for the employee is called in. Is it fair? Perhaps on the surface it appears unfair, but one must keep in perspective that a registry nurse only gets paid for the shifts that are worked. There can be, and often are, long dry spells when the registry nurse receives no assignments. Though many agencies offer perks similar to those offered by the hospital, such as health/dental insurance and 401K plans, these are only offered and maintained if the nurse works a set amount of hours per month or quarter. Though hospital-based nurses often face a similar challenge, it usually only effects part-timers. Generally, the full-time hospital-based nurse does not have to worry that their benefits will stop just because the hospital did not schedule them for some shifts. * To travel to interesting cities or countries One of the greatest attractions of working registry is being able to pretty much pick and choose the state or country where you want to work, and, in many cases, even select the hospital. Most registry and travel agency nurses have a great support system in place that can help a nurse secure a license for the state, as well as housing and transportation. Recently, an Australian registry held recruitment events in at least three major American cities to encourage US nurses to sign on to a one or two-year contract to work in Australian hospitals. I know a Canadian nurse who works with a US traveler agency that puts her to work three months of the year. So far she has worked in Arizona, New Mexico, Southern California, and Florida. She loves "vacationing" this way with her husband, who is retired, and she explores the US, while making a little extra income. * To work in certain hospitals Another plus is that registry nurses can often stipulate the hospitals where they prefer to work, and avoid those that are not welcoming of registry nurses. Hospitals sometimes put in place policies that are not registry friendly. These policies are meant to provide patient safety and to protect the hospital. However, they are often unwieldy and may result in placing the patient in harm's way. For example, one hospital in the San Gabriel Valley recently implemented a code system to access the high acuity areas of the hospital. A computer-generated access code and an individual code was issued to each hospital employee. However, the registry nurses were prohibited from receiving an access code, even a temporary code, with the reasoning that since the registry nurse was not a hospital employee, they could not be trusted with such sensitive information. Meanwhile, that same nurse who could not be trusted with a simple door access code in order to return to the unit after having used the restroom (which were located outside the unit) was entrusted with critically ill patients in NICU. Another common misconception is that registry nurses are at heart troublemakers and could not "make it" in the hospital setting. As with any situation that involves people, this misconception could have some truth to it. On the other hand, many registry nurses know the very real threat of being made a DNS --Do Not Send. The DNS is the blacklist of the nursing world. Most hospitals have no criteria for placing a registry/travel nurse on their DNS list. Since there is often very little practice-based criteria used to place a registry nurse on the list, many registry nurses try to keep a low profile at some hospitals. If you think the DNS list is just a myth, ask your staffing office. Most, if not all, will confirm that such a list exists. The original intent was to serve as a type of historical "gatekeeper" so that truly bad or incompetent nurses are not allowed to return, which is definitely a wise thing for a hospital to do. However, in some situations, little to no criteria is in place that decides when a registry nurse is placed on the DNS list.Often, it is not because of poor or dangerous nursing practice, but due to a more arbitrary reason. However, some hospitals cultivate a work environment that is welcoming to the registry/traveler nurse. The staff nurses, in turn, are generally respectful of the registry nurse's skills and treat her as a member of the regular nursing team. Creating this environment ultimately benefits the hospital and the patient. In a perfect world, nurses don't call in sick, go on leave or vacation, or miss any days of work. However, we all know how imperfect our world is, and the registry nurse serves a very real purpose. The other choice is to work even more short staffed, or require nurses to come in sick, or pull double shifts, which increases the burnout rate. The next time a registry/traveler nurse is assigned to your unit, be grateful she is there, sharing the workload. Also keep in mind that this nurse is an RN in your state, who passed the same or equivalent tests as you, and has a diploma, associate, or BSN. Try not to pass judgement on the reasons why the registry nurse has chosen to practice through the registry. Be happy that there exists a pool of nurses who don't mind being the substitute nurse when we need them to be. And, remember, how can we expect those from outside of nursing to respect us, if we cannot ourselves show respect to our fellow nurses.

Are there any registry nurses who feel they stick out like a "sore thumb" in the hospital? You will feel better when you read this article: Many staff nurses look at the registry nurse as some kind of second-class, poorly trained, third cousin to the staff nurse. This myth, in most cases, cannot be further from the truth. I have seen very competent registry nurses given lousy assignments by the charge nurse under the misguided belief that registry nurses aren't "real" nurses, or are less skilled than the hospital's own staff nurses. Are there bad or poorly trained registry nurses? Of course, just as there are bad or poorly trained staff nurses. Sure, the staffer will be more familiar with that particular hospital's protocols. But just because a nurse has chosen to practice nursing through a registry should not lead anyone, let alone another nursing professional, to believe that this nurse is any less committed to quality patient care than the nurse who has chosen to practice in the hospital setting. Our profession suffers from enough outside detractors--we do not need to join the fray as well. Several years ago I was working, through the registry, at a local Los Angeles hospital. I got called down to the ED from the NICU to start a particularly difficult IV on an infant, when the baby's mother objected to my performing the procedure. She had realized that I was not one of the regular staff RN's, since I wore my registry I.D. rather then the standard hospital I.D. The head nurse apologized to me for calling me away from my patients and sent me back to the unit. Perhaps if the head nurse had explained that the reason the ED nurses had called me down was because they knew I could start an IV in the most difficult of cases and they wanted to avoid repeatedly sticking her child--perhaps then, the mother may have let me perform the procedure. Or maybe not. But at least she would have made her decision based on facts, rather then the mistaken belief that registry nurses are somehow less skilled than staff nurses. What draws one nurse to the hospital setting and another to the registry are different challenges. Some of the reasons that a nurse may choose to work for a registry or travel agency are: * Not to have to deal with the hospital politics So many nurses are driven out of bedside nursing because of the hospital/nursing politics of a particular institution. When a nurse works through the registry, she usually shields herself from the day-to-day politics since she is there on a temporary assignment. She doesn't need to invest emotionally in interoffice concerns. Consequently, registry nurses may be less likely to suffer from burnout than staff nurses. * Have more direct control over their work schedule Working the registry usually allows the nurse to have greater control over her work schedule. She can stipulate the days and shifts she is willing to work, and when she is not. Most registry managers recognize this as one of the satisfaction indicators for their nurses and they usually do their best to accommodate requests. However, when the need arises, they call their list of available nurses to see if one wants to pick up an additional shift. When this happens, the nurse has the right to refuse without suffering consequences. Furthermore, the nurse can often negotiate higher pay for the assignment or other bonuses. * To make extra money There is no question that registry and travelers generally make more money per hour then the permanent nursing staff. This is the case in most professions where a "substitute" for the employee is called in. Is it fair? Perhaps on the surface it appears unfair, but one must keep in perspective that a registry nurse only gets paid for the shifts that are worked. There can be, and often are, long dry spells when the registry nurse receives no assignments. Though many agencies offer perks similar to those offered by the hospital, such as health/dental insurance and 401K plans, these are only offered and maintained if the nurse works a set amount of hours per month or quarter. Though hospital-based nurses often face a similar challenge, it usually only effects part-timers. Generally, the full-time hospital-based nurse does not have to worry that their benefits will stop just because the hospital did not schedule them for some shifts. * To travel to interesting cities or countries One of the greatest attractions of working registry is being able to pretty much pick and choose the state or country where you want to work, and, in many cases, even select the hospital. Most registry and travel agency nurses have a great support system in place that can help a nurse secure a license for the state, as well as housing and transportation. Recently, an Australian registry held recruitment events in at least three major American cities to encourage US nurses to sign on to a one or two-year contract to work in Australian hospitals. I know a Canadian nurse who works with a US traveler agency that puts her to work three months of the year. So far she has worked in Arizona, New Mexico, Southern California, and Florida. She loves "vacationing" this way with her husband, who is retired, and she explores the US, while making a little extra income. * To work in certain hospitals Another plus is that registry nurses can often stipulate the hospitals where they prefer to work, and avoid those that are not welcoming of registry nurses. Hospitals sometimes put in place policies that are not registry friendly. These policies are meant to provide patient safety and to protect the hospital. However, they are often unwieldy and may result in placing the patient in harm's way. For example, one hospital in the San Gabriel Valley recently implemented a code system to access the high acuity areas of the hospital. A computer-generated access code and an individual code was issued to each hospital employee. However, the registry nurses were prohibited from receiving an access code, even a temporary code, with the reasoning that since the registry nurse was not a hospital employee, they could not be trusted with such sensitive information. Meanwhile, that same nurse who could not be trusted with a simple door access code in order to return to the unit after having used the restroom (which were located outside the unit) was entrusted with critically ill patients in NICU. Another common misconception is that registry nurses are at heart troublemakers and could not "make it" in the hospital setting. As with any situation that involves people, this misconception could have some truth to it. On the other hand, many registry nurses know the very real threat of being made a DNS --Do Not Send. The DNS is the blacklist of the nursing world. Most hospitals have no criteria for placing a registry/travel nurse on their DNS list. Since there is often very little practice-based criteria used to place a registry nurse on the list, many registry nurses try to keep a low profile at some hospitals. If you think the DNS list is just a myth, ask your staffing office. Most, if not all, will confirm that such a list exists. The original intent was to serve as a type of historical "gatekeeper" so that truly bad or incompetent nurses are not allowed to return, which is definitely a wise thing for a hospital to do. However, in some situations, little to no criteria is in place that decides when a registry nurse is placed on the DNS list.Often, it is not because of poor or dangerous nursing practice, but due to a more arbitrary reason. However, some hospitals cultivate a work environment that is welcoming to the registry/traveler nurse. The staff nurses, in turn, are generally respectful of the registry nurse's skills and treat her as a member of the regular nursing team. Creating this environment ultimately benefits the hospital and the patient. In a perfect world, nurses don't call in sick, go on leave or vacation, or miss any days of work. However, we all know how imperfect our world is, and the registry nurse serves a very real purpose. The other choice is to work even more short staffed, or require nurses to come in sick, or pull double shifts, which increases the burnout rate. The next time a registry/traveler nurse is assigned to your unit, be grateful she is there, sharing the workload. Also keep in mind that this nurse is an RN in your state, who passed the same or equivalent tests as you, and has a diploma, associate, or BSN. Try not to pass judgement on the reasons why the registry nurse has chosen to practice through the registry. Be happy that there exists a pool of nurses who don't mind being the substitute nurse when we need them to be. And, remember, how can we expect those from outside of nursing to respect us, if we cannot ourselves show respect to our fellow nurses.

Are there any registry nurses who feel they stick out like a "sore thumb" in the hospital? You will feel better when you read this article: Many staff nurses look at the registry nurse as some kind of second-class, poorly trained, third cousin to the staff nurse. This myth, in most cases, cannot be further from the truth. I have seen very competent registry nurses given lousy assignments by the charge nurse under the misguided belief that registry nurses aren't "real" nurses, or are less skilled than the hospital's own staff nurses. Are there bad or poorly trained registry nurses? Of course, just as there are bad or poorly trained staff nurses. Sure, the staffer will be more familiar with that particular hospital's protocols. But just because a nurse has chosen to practice nursing through a registry should not lead anyone, let alone another nursing professional, to believe that this nurse is any less committed to quality patient care than the nurse who has chosen to practice in the hospital setting. Our profession suffers from enough outside detractors--we do not need to join the fray as well. Several years ago I was working, through the registry, at a local Los Angeles hospital. I got called down to the ED from the NICU to start a particularly difficult IV on an infant, when the baby's mother objected to my performing the procedure. She had realized that I was not one of the regular staff RN's, since I wore my registry I.D. rather then the standard hospital I.D. The head nurse apologized to me for calling me away from my patients and sent me back to the unit. Perhaps if the head nurse had explained that the reason the ED nurses had called me down was because they knew I could start an IV in the most difficult of cases and they wanted to avoid repeatedly sticking her child--perhaps then, the mother may have let me perform the procedure. Or maybe not. But at least she would have made her decision based on facts, rather then the mistaken belief that registry nurses are somehow less skilled than staff nurses. What draws one nurse to the hospital setting and another to the registry are different challenges. Some of the reasons that a nurse may choose to work for a registry or travel agency are: * Not to have to deal with the hospital politics So many nurses are driven out of bedside nursing because of the hospital/nursing politics of a particular institution. When a nurse works through the registry, she usually shields herself from the day-to-day politics since she is there on a temporary assignment. She doesn't need to invest emotionally in interoffice concerns. Consequently, registry nurses may be less likely to suffer from burnout than staff nurses. * Have more direct control over their work schedule Working the registry usually allows the nurse to have greater control over her work schedule. She can stipulate the days and shifts she is willing to work, and when she is not. Most registry managers recognize this as one of the satisfaction indicators for their nurses and they usually do their best to accommodate requests. However, when the need arises, they call their list of available nurses to see if one wants to pick up an additional shift. When this happens, the nurse has the right to refuse without suffering consequences. Furthermore, the nurse can often negotiate higher pay for the assignment or other bonuses. * To make extra money There is no question that registry and travelers generally make more money per hour then the permanent nursing staff. This is the case in most professions where a "substitute" for the employee is called in. Is it fair? Perhaps on the surface it appears unfair, but one must keep in perspective that a registry nurse only gets paid for the shifts that are worked. There can be, and often are, long dry spells when the registry nurse receives no assignments. Though many agencies offer perks similar to those offered by the hospital, such as health/dental insurance and 401K plans, these are only offered and maintained if the nurse works a set amount of hours per month or quarter. Though hospital-based nurses often face a similar challenge, it usually only effects part-timers. Generally, the full-time hospital-based nurse does not have to worry that their benefits will stop just because the hospital did not schedule them for some shifts. * To travel to interesting cities or countries One of the greatest attractions of working registry is being able to pretty much pick and choose the state or country where you want to work, and, in many cases, even select the hospital. Most registry and travel agency nurses have a great support system in place that can help a nurse secure a license for the state, as well as housing and transportation. Recently, an Australian registry held recruitment events in at least three major American cities to encourage US nurses to sign on to a one or two-year contract to work in Australian hospitals. I know a Canadian nurse who works with a US traveler agency that puts her to work three months of the year. So far she has worked in Arizona, New Mexico, Southern California, and Florida. She loves "vacationing" this way with her husband, who is retired, and she explores the US, while making a little extra income. * To work in certain hospitals Another plus is that registry nurses can often stipulate the hospitals where they prefer to work, and avoid those that are not welcoming of registry nurses. Hospitals sometimes put in place policies that are not registry friendly. These policies are meant to provide patient safety and to protect the hospital. However, they are often unwieldy and may result in placing the patient in harm's way. For example, one hospital in the San Gabriel Valley recently implemented a code system to access the high acuity areas of the hospital. A computer-generated access code and an individual code was issued to each hospital employee. However, the registry nurses were prohibited from receiving an access code, even a temporary code, with the reasoning that since the registry nurse was not a hospital employee, they could not be trusted with such sensitive information. Meanwhile, that same nurse who could not be trusted with a simple door access code in order to return to the unit after having used the restroom (which were located outside the unit) was entrusted with critically ill patients in NICU. Another common misconception is that registry nurses are at heart troublemakers and could not "make it" in the hospital setting. As with any situation that involves people, this misconception could have some truth to it. On the other hand, many registry nurses know the very real threat of being made a DNS --Do Not Send. The DNS is the blacklist of the nursing world. Most hospitals have no criteria for placing a registry/travel nurse on their DNS list. Since there is often very little practice-based criteria used to place a registry nurse on the list, many registry nurses try to keep a low profile at some hospitals. If you think the DNS list is just a myth, ask your staffing office. Most, if not all, will confirm that such a list exists. The original intent was to serve as a type of historical "gatekeeper" so that truly bad or incompetent nurses are not allowed to return, which is definitely a wise thing for a hospital to do. However, in some situations, little to no criteria is in place that decides when a registry nurse is placed on the DNS list.Often, it is not because of poor or dangerous nursing practice, but due to a more arbitrary reason. However, some hospitals cultivate a work environment that is welcoming to the registry/traveler nurse. The staff nurses, in turn, are generally respectful of the registry nurse's skills and treat her as a member of the regular nursing team. Creating this environment ultimately benefits the hospital and the patient. In a perfect world, nurses don't call in sick, go on leave or vacation, or miss any days of work. However, we all know how imperfect our world is, and the registry nurse serves a very real purpose. The other choice is to work even more short staffed, or require nurses to come in sick, or pull double shifts, which increases the burnout rate. The next time a registry/traveler nurse is assigned to your unit, be grateful she is there, sharing the workload. Also keep in mind that this nurse is an RN in your state, who passed the same or equivalent tests as you, and has a diploma, associate, or BSN. Try not to pass judgement on the reasons why the registry nurse has chosen to practice through the registry. Be happy that there exists a pool of nurses who don't mind being the substitute nurse when we need them to be. And, remember, how can we expect those from outside of nursing to respect us, if we cannot ourselves show respect to our fellow nurses.

Here is an interesting article about sleeping on the job, I found it very interesting. http://www.workingworld.com has very good articles related to nursing. Not that long ago, the administration of a local hospital conducted a surprise visit to its NICU unit. During the visit, the administrators found many of the nurses sleeping at the bedside and at the nurses' station. The hospital promptly fired them for dereliction of duty. Though it may have been a harsh action for the administration to take, it was appropriate, since sleeping at the bedside is should never be condoned. I have seen this practice growing in NICU and it concerns me that nurses would allow themselves to be seen sleeping at the bedside as if it somehow shows what truly dedicated professionals they are, when in reality, sleeping at the bedside is the last thing a nursing professional would do. Nurses fall into this practise when one or more members of the nursing team, usually in a position of authority (either real or perceived), does it and encourages others to do it as well. Once the other nurses have joined in, no one feels comfortable reporting the inappropriate behavior since they are guilty of it as well, so the practice continues. I know because I have had the experience of nurses trying to encourage me to sleep at the bedside, though I always refuse. However, this doesn't mean that nurses should not be allowed to sleep or nap when it's their break time. Unfortunately, many hospitals prohibit nurses from sleeping, even on their own time. The negative connotation of "sleeping on the job" is commonly held throughout the American workplace. It shouldn't be. The good news is that there is a great deal of recent research on what has been termed "power napping" on work performance. Studies, both controlled and anecdotal, have been published showing an increase in employee efficiency and productivity after a 15- or 20-minute nap. The challenge for nurses is to get hospitals to acknowledge that napping can actually benefit their nursing workforce. It is indeed a challenge, especially since the health care industry in general, and hospitals in particular, are often most comfortable with the status quo and reluctant to implement new concepts or new technology. Back when I was a Director of Nursing, I had a very different opinion on nurses using their breaks to nap; I thought it would be perceived as unprofessional and I didn't see that it would benefit work performance. However, I began to alter my opinion on the matter after doing a quality assurance project at a Los Angeles area hospital. The chief physician in one of the specialty units used me, as a consultant, to assess the quality of care and to help track down an ongoing infection problem that no one seemed to be able to figure out. So, off to work I went as a NICU/PICU/Transplant nurse for several months. It was during these long days and nights that I learned that the hospital had set aside a room on each floor where the nurses could sleep during their breaks. The room wasn't fancy and the beds were just reclining loungers, but it was a quiet, dark place where a tired nurse could catch 40 winks. The only rules were: we could only use the room on our breaks, and we must answer if an urgent page was sent--both good rules. After finishing my six months undercover work (and yes, we did track down the source of infection), I began to rethink my position on sleeping on the job. I hope that this article will encourage my nursing peers to bring this topic up with their nursing administration, using the chain of command, of course. Here are some quick facts and figures on "power napping": * It has been estimated that reduced productivity due to sleep deprivation costs U.S. businesses an estimated $18 billion per year. * Studies on power napping show that well rested employees are more alert and have faster reaction times, improved problem-solving skills and increased creativity. All three points have a direct impact on nurses and their work. * Who needs artificial stimulants when a quick nap can make nurses feel more alert and healthy? According to a report in Psychology Today, one California firm that implemented napping reported a 30 percent decrease in expenditures on caffeinated soda and coffee. * Additionally, studies done by Alan Hobson, MD, Robert Stickgold, PhD., and other Harvard colleagues show that short naps after lunch may be more effective than the post-lunch coffee break. Their research has also shown that naps enhance information processing and learning. So, a quick sleep makes us smarter and better learners, which tranlates to better patient care and safety. It may not be easy for nurses to get the administration to agree to set up "nap rooms." You are working against an institutionalized prejudice against "sleeping on the job," but it doesn't mean that it is impossible to implement change. If your hospital is more progressive, and you already have "nap rooms" or designated places where employees can sleep during their time off (and by this I don't mean your car), then congratulations! However, remember to obey the rules on usage and always keep the area neat so privileges don't get revoked. Then share the information with fellow nurses from other hospitals where they don't have designated nap rooms, and offer to help them if they call upon you to speak about it to their superiors. For those among you who would like to advocate for nap rooms, try some of the following procedure. Remember, the objective is to provide the nurses, especially those working 12-hour shifts, a safe place to sleep away from the bedside: * Open up the topic of discussion with your peers. Are they interested in having a designated nap room? If there is interest, then take it to the next level. * Approach your Head Nurse/Charge Nurse with the idea of developing designated nap rooms. Ask your peers who share the same interest to also express their desire. If you know of a local hospital that has designated nap rooms, ask someone from that hospital to come speak to your superiors and share first-hand information. Share with your superiors information on the positives of "power napping." * If your idea receives positive feedback, be sure to make it clear that you are willing to speak on the subject to the "big wigs" if your superior desires it. Be sure to ask your superior what they think the next steps are and how they think the nurses can be of assistance. * You can also put your request in writing, documenting your idea and providing supportive documentation; then submitting it for consideration to the nursing management. * And remember to talk it up, talk it up, talk it up. Once you have put the campaign into motion, you want to keep track of its progress. Don't assume that if everyone seems enthusiastic that it will get the seal of approval and just magically get done. In almost all instances, even the most perfect idea has its detractors. For example, at a hospital at the eastern edge of Los Angeles County, the administration is so opposed to employees sleeping on the job that even if that employee is on break (and they make employees clock in and out for breaks, so this is the employee's own time), they aren't allowed to sleep in their own car. Now this is an extreme example, but I use it to remind my readers that you will face the spectrum from, "Oh wow what a great idea, let's get right on it," to, "No way, no how." The key is to first hope for a positive reception to the idea. If you have a more hard-nosed administration, it may require more effort and long-term planning. Decide if your nursing colleagues and you are in it for the long haul. If the answer is yes, then begin slowly and keep the discussions ongoing. For example, whenever you find an article in the newspaper or research journal, cut it out, copy it, and forward it to the appropriate person. Keep the discussion alive by bringing it up at staff meetings whenever appropriate. Note, the key word here is appropriate. Remember, never sleep at the bedside or at the nurses' station; it is unprofessional and unbecoming of nurses. Instead, encourage your nursing administration to designate nap rooms. Nurses work long shifts and do deserve to have a safe place to sleep or relax when they are on break. As a result, the hospital can reap the benefits of a nursing staff that is happy, refreshed, more productive, and less likely to make medical errors.

Many years ago, when I was director of nursing at a hospital in east San Gabriel Valley, I was confronted by patients and patient's families expressing grievances during the 1500-1900 shift. This shift had a disproportionate number of complaints. Yet, I knew that the nursing staff on this shift was both competent and efficient, so I wondered what was the problem could be. I set about observing the nurses as they worked. It didn't take long to realize that the problem wasn't so much the nurses's skills, but how they executed their work. For some reason, this shift had a disproportionate number of nurses who were task-oriented and it was this behavior that was at the heart of the problem. Individuals exhibit both a variety and a continuum of behaviors, but many of us have certain traits that mark us as either a task-oriented or a nurture-oriented person. It is one of these two modes that defines how we organize and execute our work. Being aware of your predilection can help you work more smoothly with your fellow nurses, customize your interaction with patients and their families, and even be more effective as a nurse. The task-oriented (Type A) nurse will usually have a To Do list, with an idea of how much time each task will take. This nurse will plan breaks and meal times around a schedule of work responsibilities. She is usually praised for her organizational skills. The nurture-oriented (Type B) nurse is more focused on the interpersonal aspects of her work. Her focus is on meet ing the emotional/spiritual needs of her patients. The task itself is secondary. Problems generally arise when the ratio of Type A and Type B nurses are out of sync, as this can lead to subtle and not so subtle conflicts among the nursing team, as well as complaints from patients and their families. A "Type A" nurse may: * Fight to get one of the limited number of scales available to weight her baby, rather than wait until later, when there is less demand; * Get that patient out of bed and sitting up in the chair at the designated time, even if the patient is engaged in some other activity; * Change the dressing of the patient's open wound, even though housekeeping is in the room vacuuming and doing other cleaning tasks; * Arrive 15 minutes or more before the shift is set to begin; * Collect all the necessary equipment for the lab tests ordered, even if the labs don't need to be sent in until end of shift--twelve hours later; or, * Stick a patient to get that IV started even if it means trying 13 times. A "Type B" nurse may: * Arrive late for the start of your shift because she is busy talking to everyone in the nursing office, cafeteria, hallway, and parking lot; * Know the entire life story of each and every one of her patients; * Leave the bay supplies more depleted, or in more chaos, than when she arrived; * Be looking for the supplies needed to draw the labs that were due in the lab 20 minutes ago; * Know that it just isn't her day to start a patient's IV if by the third attempt she has still been unsuccessful; * Be overhead saying, "but it's an organized mess." So, which "type" makes the perfect nurse? If your answer is both and neither then you'd be right. A strictly "Type A" nurse is the nurse caricature that we all dread and hate--this is the Nurse Ratched stereotype that dogs our profession to this day. Meanwhile, the "Type B" nurse is the one we all dread to work with because she is so busy with the "touchy-feely" side that no tasks get done. Nursing teammates are often left to do her work in addition to their own. The best nursing model is a blend of the two types. Most of us shift between the two types, adjusting our style as needed. Problems arise when we become stuck in one style of behavior. We may not always be aware of our proclivities, but our fellow coworkers generally are. Any NICU nurse, especially those who work the night shift, knows of the mad dash to get all babies weighed at the start of shift. When Type A nurses make up the majority on the shift, there is an almost comic, and sometimes stressful, ballet as each nurse tries to secure one of the few scales that are available for this function. A Type B nurse would generally choose to wait a little later in the shift to do the weigh-in (especially if it is not a time-sensitive task) and let the Type A's "duke it out" over the limited number of scales. When Type B nurses make up a large percentage of your nursing team, things like restocking the bay or calling in all the labs, etc., might not get done in a timely manner, since they may focus most of their work time interacting with other nurses, the patient, or the patient's family. Neither scenario is an example of "bad" nursing. The solution lies in a strong manager who can identify the traits of her nurses and try the following solutions: * Redistribute the "mix" of personality types, ensuring that one type does not dominate. * Hold in-services for the nursing teams so they can learn to identify and integrate their styles into their work. * Help an over-strong Type A or Type B personality learn how to moderate the behavior so that it does not continue to overwhelm the other nurses, patients, and themselves. Good and competent nursing leadership, from both the nursing management and from the nurses themselves, is a critical element in a nursing team that excels in its work and provides the best of patient care. Knowing what personality trait you are likely to exhibit, especially in moments of stress, can help you to be a better nurse. No one style is always superior to the other. However, knowing when and how to shift from one style of behavior to the other can help you perform in an even more effective manner, and interact better with the other members of the nursing team.

Thank you very much for the information, it was helpful.

Thank you very much for the information, it was very helpful.

Hello everyone, I recently moved to the Orlando area and wanted to know the salary for LPNs. Also what are some great facilities to work at. Hospital vs. LTC or Home care. Any ideas or suggestions are welcomed.:)